Secure Loan Application Form

Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:

you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI)

your spouse will use the account, or

you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying.

Joint Credit: Each Applicant must individually complete the appropriate section below, If Co-Borrower is spouse of the Applicant,- mark the Co-Applicant box.

Guarantor: Complete the Other section if you are a guarantor on an account/loan.

Are you applying for individual or joint credit ?: Individual
Joint

Type of Loan Applied For:

NOTE:
You must have a minimum of 6 mos. employment to be eligible to apply for a vehicle/secured loan, 2 yrs. for a signature loan, or 5 yrs. for a premium personal loan.
Please fax a copy of your most recent paycheck stub to our office @ (630) 416-4918.

Signature (up to $5000)
Premium Personal (up to $10,000)
New Car
Used Car

Please indicate your marital status if you are applying for joint credit, secured credit or if you live in a community property state:

Marital Status:

Home Phone #:

Cell Phone #:

Work Phone #:

Street Address:

City:

State:

Zip #:

Current Address since:

(MM/YY)

If less than 3 yrs enter previous address:

Joint Applicant's Name:

Account #:

Social Security #:

Work Email:

Home Email:

US Citizen:

Yes
No

Birthdate (MM/DD/YY):

Please indicate your marital status if you are applying for joint credit, secured credit or if you live in a community property state:

Marital Status:

Home Phone #:

Cell Phone #:

Work Phone #:

Street Address:

City:

State:

Zip #:

Current Address since:

(MM/YY)

If less than 3 yrs enter previous address:

Employment Information

EMPLOYMENT AND INCOME: In order to expedite the processing of your loan application, please fax a copy of your most recent paycheck stub to (630) 416-4918. If you have a joint applicant (cosigner) their paycheck stub must be faxed as well. If you are self employed or retired, you may fax a financial statement or tax return for income verification.

Applicant Employer's Name:

Employer Phone #:

Employer Address:

Position:

Date Hired (MM/DD/YY):

Monthly Gross Income ($):

Other Income ($):

per Month

Source of Other Income:

Complete if current employment is less than 2 years:
Previous Employers Name:

Yrs Employed:

Joint App. Employer's Name:

Employer Phone #:

Employer Address:

Position:

Date Hired (MM/DD/YY):

Monthly Gross Income ($):

Other Income ($):

per Month

Source of Other Income:

Complete if current employment is less than 2 years:
Previous Employers Name:

Yrs Employed:

NOTE: Alimony, child support, or separate maintenance
income need not be revealed if You do not choose to have it considered
as a basis for this credit request.

References (Nearest relative not living with you)

First Name:

Middle Name:

Last Name:

Suffix:

Cell Phone Number:

555-555-5555

Home Phone Number:

555-555-5555

What is their home address?

Street:

City:

State:

Zip:

What is the relationship?

Debts & Assets

Applicant

Joint Applicant

Lender

Mo. Payment

Lender

Mo. Payment

Housing
Rent
Own
None

$
.00

Housing
Rent
Own
None

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

$
.00

Child Support Payments / Alimony

$

Assets:

Description:

Value:

Description:

Value:

Have you ever filed for bankruptcy or had debt adjustment under Chapter 13?

Are you a party in a lawsuit?

Have you ever had property foreclosed or repossesion in the last 7 years?

Is your income likely to decline in the next two years?

Are you co-maker/endorser on any loan not listed above?

If yes then for whom?

If yes then to whom?

Complete the following sections if you are applying for a vehicle loan:

If Private Party Purchase:
If private party still has a loan against the vehicle and
the title is held by a leinholder:
Name of Finance Co. holding title:
Phone# of Finance Co.:
Account#:
Approximate payoff:
Address:

Additional Comments

Additional Comments:

Submit Application

You promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of what you owe. If there are any important changes you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.

By pressing the "Submit Form" button below, you agree to the above statement. You understand that we may require your signature on additional documents prior to disbursing any credit proceeds.